Doctro Shortge - Doctor Shortage Deepens.

Preface: The deepening doctor shortage is one of the main themes of my book Obama, Doctors, and Health Reform. To show you the shortage in not something I dreamed up, I reprint here two recent pieces on the subject. Ironically, one of the most severely short states of primary care doctors is Massachusetts, which has the second highest concentration of physicians per capita next to the District of Columbia. For the last three years, Massachusetts has had a universal coverage plan and is widely touted among liberals as a model for widening coverage. It is a paradox that Massachusetts now has the nation’s longest waiting times to see a doctor and its ERs are consequently overwhelmed. This is a beautiful example of unanticipated adverse consequences.

Fierce Healthcare, December 7, 2009

Physician shortage is getting worse

By Anne Zieger

Brace yourselves: Demand for physicians continues to outstrip supply, and the problem is likely to get worse, according to new data.

One source underscoring the problem is the Bureau of Labor Statistics, which concluded last month that the healthcare sector added 28,500 jobs in October. That included 4,800 jobs in physician offices and 10,000 in hospitals.

While the BLS report doesn't break down these jobs into specific job titles, another report by healthcare staffing firm AMN Healthcare Services offers a more-detailed picture. The firm's report, conducted in partnership with the Council on Physician and Nurse Supply, surveyed 284 hospital chief executive officers between June and August of this year.

Researchers found that about 95 percent of those CEOs reported a physician shortage, with a vacancy rate of 11 percent, potentially compromising care in almost half of those cases. This was despite the fact that 34 percent of the CEOs had increased their physician staff roster within the previous six months.

Meanwhile, physician vacancies aren't the only major headache hospital CEOs face. Ninety-one percent of CEOs said that they were seeing a nursing shortfall, though the vacancy rate was just 6 percent.


AMA News, December 7.2009

Victoria Stagg Elliot

About 1 in 10 physician jobs are unfilled, hospitals say

Despite the recession, hospitals are still seeing a doctor shortage, a survey by one physician placement company finds.The health care system added more jobs in October, but efforts to meet the increasing demand for services are hampered by a worsening physician shortage, leaving some institutions struggling to fill some jobs, according to a pair of recently released reports.

"A friend once said to me that, without doctors, hospitals are just mediocre hotels with average food," said Kurt Mosley, vice president of business development at AMN Healthcare Services Inc. "Without the doctors, hospitals would not exist. There is such a demand for doctors. There are so many opportunities." AMN is the largest health care staffing firm in the country.


According to a report issued by the Bureau of Labor Statistics Nov. 6, the economy as a whole lost 190,000 jobs in October and the unemployment rate increased to 10.2%
. The health care sector, however, added 28,500 jobs, with 10,000 of those in hospitals and 4,800 in physician offices.

This agency does not break down numbers by profession. But a separate report issued by AMN indicated many clinical professionals, particularly physicians, are in short supply.

AMN, in partnership with the national Council on Physician and Nurse Supply, surveyed 284 hospital chief executive officers, during June through August, about physician job openings at their facilities.

Approximately 95% of the hospital CEOs said there was a shortage of physicians, with a vacancy rate of 11%, meaning a little more than one in 10 physician job openings are unfilled.

About 34% of CEOs had increased the number of physicians on staff within the previous six months, but 46% said patient access to care had been compromised by shortfalls in the number of physicians.

The amount of money put into physician recruitment has, however, gone down, although this report suggests it most likely will return to pre-recession levels soon. According to third quarter results from AMN, a publicly traded company, revenue from locum tenens physicians decreased 12% over the past year. Money earned from placing physicians decreased by 31%. But this survey found that 54% of CEOs plan to increase physician recruitment efforts.

"It seems to have hit the bottom, and business is coming back," Mosley said. "It wasn't that the demand was not there, but recruiting a doctor is a half a million dollar outlay. It wasn't that [hospitals] didn't want to recruit. They had no funds to do it."

Merritt Hawkins & Associates is the company owned by AMN that handles permanent physician placement. Staff Care manages locum tenens assignments.

Nurses also remain in short supply, although this is not felt as acutely as the physician shortage, with 91% of hospital CEOs noting a shortfall. Some 32% of institutions had increased their number of nurses, and the vacancy rate for nurses was 6%. Only 8% of hospital CEOs said access to care was compromised because of a lack of nurses.

The recession has helped ease the nursing shortage, 27% of hospital CEOs said. Experts say the economic downturn brought retired nurses or those working in other industries back into the field and many nurses who had been working part-time expanded their hours. Shortages are expected to return to previous levels as the economy recovers.